بسم اهلل الرحمن الرحيم

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Jessica Ferguson
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1 بسم اهلل الرحمن الرحيم Adoption and economics of Femtosecond laser lens and cataract surgery in Egypt Osama M Al Nahrawy, MD Ophthalmology Dept, Suez Canal Universitty The annual conference of the Egyptian Society of Ocular Implants and Refractive Surgery, ESOIRS,

2 Laser Cataract Surgery: the Next New Thing in Ophthalmology A big international wave Better called : Laser Lens Surgery

3 Automation of surgery, raising safety and efficacy and outcomes

treatment plan Curved Patient Interface Anterior

4 Integrated Online OCT Imaging for Procedure Planning & Monitoring Arcuate corneal incision treatment plan Curved Patient Interface Anterior capsulotomy treatment plan Anterior capsule Posterior capsule

5 Laser Cataract Cuts Capsulotomy Lens fragmentation LRI LRI Sec. incision Prim. incision

6 Facilitating Nuclear Craking (It is not complete) Care should be taken that: Nuclear craking is partial, Not reaching the posterior pole and plate and Not extending to the equator We need some phako power (30-50%). Tough posterior plate and equatorial parts need effor to complete the craking

7 Summary of advatages of femtophako Anaethesia topical Open eye time reduced Reduction of amounts of viscoelastics Shorter effective phako time Automation instead of manual.

$Patients who had a complication in the other eye Refractive lens echange Previous RK with$

8 Indications or prefered conditions to choose femtlaser One-eyed patients with cataract. Patients who had a complication in the other eye Refractive lens echange Previous RK with cataract.

9 Companies that produced the technology Technolas Perfect Vision Vectus LensAR, Florida, ALCON LenSx OptiMedica Catalase

10 Technology adoption life cycle

11 Rate Of Diffusion According to Everett M. Rogers, the rate of diffusion is influenced by: The product's perceived advantage or benefit. Riskiness of purchase. Ease of product use - complexity of the product. Immediacy of benefits. Observability. Trialability. Price. Extent of behavioural changes required. Return on investment in the case of industrial products.

13 CE Mark approval of Victus

14 VIDEOS

18 WHO WILL PAY FOR IT? Many surgeons wonder, who is going to pay for the procedure? That answer is easy: the patient. Medicare or health insurance will not.

19 Economics Stop low pricing policies? Strategies for helping your patient: give him an example of how to get fund: 1. Bank payment for surgery: فتوى دار اإلفتاء إذا توسطت الخدمة او السلعة فال ربا 2. To sell something owned 3. Affordable care concepts :.1

20 Economic status of Egyptian Population The World Bank Latest statistics: 40% of Egypt's 80 million people live on or below the $2 per-day poverty line. About 57% of the total population in Egypt lives in rural areas, where poverty prevails. Inspite of these estimates, The Affordability of many Egyptains is good (they pay for PKPs up to 20000, for vitrectomies up to 15000, for phakos up to 8000, for other general surgeries even higher)

21 Estimated costs of femto cataract Items: Machine price (more than $) Per click licence fees up to 280 $ Interface cone 60 $ Phako machine IOL and viscolesatics Other overheads Not less than 4000 Egyptian pounds without surgeon fees A figure of Egyptian pounds total fees would sound acceptable.

22 Video and data collections Turkey (Istanbul) visit (Dr Sinan Goker, others) Egyptian Group Paris live surgery symposium (Dr Auclin, Dr Baudoin, Dr Denoyez) Germany (Dr Auffarth, Heildeberg University) Check republic (Dr Studolka, Gimini Hospital) England (Dr Sheraz Daya, London) India (Dr Reddy, Hyderabad, Maxivision centers)

23 World s first femtosecod laser cataract surgery machine launched in Hyderabad Thursday, February 02, 2012, 08:00 Hrs

24 A. P. J. Abdul Kalam, the former President of India launching the VICTUS Femtosecond Laser Cataract Surgery Machine installed at the Maxivision in Hyderabad, at February 2012.

25 Dr. Stodulka, the first Czech adopter

26 300 laser cataract surgeries on VICTUS femtosecond laser platform

27 Thank you for your attention

بسم هللا الرحمن الرحيم. Femto Second Laser-assisted Cataract Surgery (FLACS): where are we now?

بسم هللا الرحمن الرحيم. Femto Second Laser-assisted Cataract Surgery (FLACS): where are we now? بسم هللا الرحمن الرحيم Femto Second Laser-assisted Cataract Surgery (FLACS): where are we now? Osama Al Nahrawy, MD. Suez Canal University, Head of Egyptian Femto Society 11 th International RIO meeting,